M -CLUSTER NEEDS A I D PERSONS OUTSIDE C · In line with the 2015 Humanitarian Response Plan’s “Whole of Iraq” Approach,3 this MCNA II ... (HRP) for 2016. The MCNA ... Rate

MULTI-CLUSTER NEEDS ASSESSMENT OF INTERNALLY

DISPLACED PERSONS OUTSIDE CAMPS

IRAQ

ASSESSMENT REPORT

OCTOBER 2015

Multi-Cluster Needs Assessment for Internally Displaced Persons Outside of Camps in Iraq – October 2015

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Cover image: ©REACH, 2015

About REACH Initiative

REACH is a joint initiative of two international non-governmental organizations - ACTED and IMPACT Initiatives -

and the UN Operational Satellite Applications Programme (UNOSAT). REACH was created in 2010 to facilitate

the development of information tools and products that enhance the capacity of aid actors to make evidence-

based decisions in emergency, recovery and development contexts. All REACH activities are conducted in

support to and within the framework of inter-agency aid coordination mechanisms. For more information about

REACH and to access our information products, please visit: www.reach-initiative.org. You can also write to us

at: [email protected] and follow us @REACH_info

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SUMMARY

The current Iraqi internal displacement crisis originated with conflict in Anbar governorate between Armed

Groups (AGs) and the Iraq Security Forces in late 2013, which in June 2014 rapidly spilled into Ninewa and other

central governorates of Iraq. The spread of insecurity led to large scale displacement with 3,171,606 internally

displaced persons (IDPs) identified across the country. By the end of July 2015, the governorates hosting the

majority of the IDP caseload were Anbar (18%), Baghdad (17%), Dahuk (13%), Kirkuk (13%), Erbil (9%) and

Ninewa (6%).1 As the conflict shows little sign of abating soon, most IDPs are unable to safely return home and

are facing either protracted displacement in their current location or multiple displacement to safer areas. Many

IDPs are in dire need of assistance and few have the capacity to deal with longer-term displacement.

The latest Multi-Cluster Needs Assessment (MCNA II) is the second of its kind conducted by the REACH

Initiative in Iraq. The assessment follows the October 2014 MCNA I2, which was conducted at the request of the

Kurdistan Regional Government (KRG) and represented the first baseline dataset on broad multi-cluster priority

needs of IDPs living outside camps in the KRI – which at the time, had received the large majority of IDPs in Iraq.

Since then, continued insecurity in the north and central region of Iraq, including Anbar and Salah al Din

governorates has caused an increasing number of displaced individuals to arrive in more central and southern

governorates. In line with the 2015 Humanitarian Response Plan’s “Whole of Iraq” Approach,3 this MCNA II

report encompasses both the KRI and accessible areas in the rest of Iraq – in total 14 of all 18 governorates4 – in

an effort to provide an updated multi-sectoral understanding of the situation facing the internally displaced

population living outside camps in all accessible areas of Iraq. The broad coverage of the assessment, based on

a total of 5,225 household level interviews, establishes the baseline multi-cluster needs assessment in the

centre-south5 and allows for country-wide comparisons at the governorate level. In addition, analysis of changes

over time in the Kurdistan Region of Iraq (KRI) can be explored between MCNA I and II.

The findings of the report informed the upcoming September 2015 Humanitarian Needs Overview (HNO) in Iraq

and upcoming Humanitarian Response Plan (HRP) for 2016. The MCNA II therefore provided a quantitative

evidence base for decision makers with the purpose of planning, sector prioritization and for target group

identification. Due to its timing, the report also captured the priority needs of IDPs outside camps ahead of the

upcoming winter season. The indicators and questionnaire for this assessment were developed in collaboration

with cluster leads and humanitarian agencies, with primary data collected between 14 May and 21 June.

The assessment found that in the immediate term, food, water and shelter remain the priority needs for IDPs

living outside camps across Iraq. However, clear variations in the conditions and levels of assistance received by

IDPs in the northern governorates compared to central and southern governorates need to be taken into account

in a Whole-of-Iraq approach. IDPs in the KRI continue to struggle to access to employment and are thus sinking

into debt, foregoing other critical needs such as medical care and education in order to make ends meet. In

contrast, IDPs in the centre and south have more restricted access to basic services overall, more frequently

change location, and are often more exposed to immediate at-risk environments.

1 International Organisation for Migration, Displacement Tracking Matrix, Round XXIV Report, July 2015. 2 REACH Initiative, Multi-Cluster Needs Assessment for Internally Displaced Persons Outside of Camps in the Kurdistan Region of Iraq, December 2014. 3 OCHA, Iraq Humanitarian Response Plan, June 2015, p.14. 4 Baghdad, Anbar, Kirkuk and Salah al Din governorates were not assessed due to security concerns and authorization issues. 5 For the sake of analysis, Iraq is divided into four main regions. The Kurdistan Region of Iraq (KRI) includes: Dahuk, Erbil and Sulaymaniyah governorates. The North includes the KRI, Ninewa and Diyala (as only areas closer to the KRI were accessible in the two latter) governorates. The Centre includes Anbar, Babylon, Baghdad, Kerbala, Kirkuk, Salah al Din, and Wassit. South Iraq includes Basrah, Missan, Najaf, Thi Qar, Qadissiya and Muthanna.


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Key findings from the assessment include, but are not limited to, the following:

Food Security: Food was the top priority need across Iraq, reported by 72% of households. Food

Consumption Scores6 were generally lower in the central and southern governorates than in the

KRI and neighbouring governorates. The combination of the widespread use of coping strategies by

IDP households, high rates of unemployment, low incomes, and high reliance on cash to purchase food,

indicates that current levels of food consumption are unlikely to be affordable in the longer term.

Livelihoods: Employment was the second most reported priority need across Iraq, reported by 42%

of households. The majority of IDP households across Iraq do not have access to any regular form of

income, often as a direct result of displacement. Employment rates were generally poorer in the

central-southern governorates compared to the north. That said, use of coping mechanisms to deal

with limited livelihoods was reported particularly often in the KRI. The level of debt in the KRI has

quadrupled since the previous MCNA, while the proportion of households in debt has remained

stable. This indicates that many households are sinking deeper into debt. The primary reason for debt

was rent, as well as food and medical costs.

Shelter: The central and southern governorates saw a higher proportion of households living in

“critical” shelters (often unfinished or abandoned buildings, schools or religious centres, and informal

tented settlements) than in the KRI. Households raised concerns regarding the upcoming winter: 56% of

IDPs in critical shelters did not feel that their shelter was of adequate quality - mostly citing

overcrowding and poor shelter conditions. Shelter concerns are closely related to livelihoods: one

of the main reasons for households taking on debt was to meet rental costs. With approximately

72% of those residing in houses or apartments renting, this raises acute concerns over affordability and

sustainability of rented shelter arrangements.

Health: A quarter of IDP households reported medical care as one of their top three priority

needs. Problems accessing healthcare were especially common in Thi-Qar as well as the KRI and

surrounding areas. Findings indicate that households are foregoing healthcare in the face of limited

finances. Immunisation rates against polio and measles were reportedly much lower in central-

southern governorates than in the northern governorates of Dahuk, Diyala, Erbil, Ninewa and

Sulaymaniyah.

WASH: The reliance on purchased water for drinking was high in southern governorates, on

average 63% with up to 95% in Kerbala indicating either that the availability of public supplies of water

is insufficient or that available water considered unsafe for drinking. Shortages in non-drinking water

were also generally more common amongst households living in critical shelters in the central-

southern governorates. Majorities in all governorates reported access to functional latrines apart from

Muthanna, but access to private latrines was much lower amongst critical shelters.

Education: IDP attendance in formal education is extremely low compared to that of their host

communities and to attendance rates prior to displacement across Iraq, particularly in the central and

southern governorates. Across all of the assessed governorates, only 20% of eligible IDP school-aged

children reportedly attend formal education. Reasons for non-attendance in the KRI and

neighbouring governorates were more commonly reported to be related to the quality of curriculum and

language, whereas in central-southern governorates reasons given for non-attendance were more

closely linked to movement and frequent displacement.

6 A measure of the frequency of consumption and the nutritional value of food consumed. For the MENA region, including Iraq and Syria, WFP interprets an FCS score of 28 or under to indicate a poor food consumption profile; a score from 28.1 through 42 to be borderline; and an FCS score above 42 to indicate an acceptable food consumption profile of food security.


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CONTENTS

SUMMARY .............................................................................................................................................................. 2

CONTENTS ............................................................................................................................................................. 5

CONTEXTUAL OVERVIEW ......................................................................................................................................... 7

METHODOLOGY ...................................................................................................................................................... 8

Limitations ............................................................................................................................................. 9

KEY FINDINGS ...................................................................................................................................................... 10

Assessed population profile ................................................................................................................. 10

Food Security ...................................................................................................................................... 13

Livelihoods .......................................................................................................................................... 17

Shelter ................................................................................................................................................. 20

Health .................................................................................................................................................. 21

Water and Sanitation ........................................................................................................................... 23

Education ............................................................................................................................................ 25

CONCLUSION ........................................................................................................................................................ 27

ANNEX I ............................................................................................................................................................... 29


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Abbreviations and Acronyms FCS IDP IQD HNO HRP KRG KRI MCNA MOP NFI NGO ODK PDS UN UNHCR USD WFP

Food Consumption Score Internally Displaced Person Iraqi Dinar Humanitarian Needs Overview Humanitarian Response Plan Kurdistan Regional Government Kurdistan Region of Iraq Multi-Cluster Needs Assessment Ministry of Planning Non-Food Items Non-Governmental Organisation Open Data Kit Public Distribution System United Nations United Nations High Commissioner for Refugees US Dollars World Food Programme

List of Figure and Maps Figure 1: Type of assistance received since arrival at their current location as reported by households .............. 11

Figure 2: Priority needs as reported by households .............................................................................................. 12

Figure 3: Average Food Consumption Score, by governorate .............................................................................. 13

Figure 4: Primary reported food sources ............................................................................................................... 14

Figure 5: Average reported household food expenditure and income in the 30 days preceding assessment (USD)

.............................................................................................................................................................................. 16

Figure 6: Coping strategies as employed by households across all assessed governorates at least once a week

.............................................................................................................................................................................. 16

Figure 7: Proportion of households by primary source of income and governorate .............................................. 17

Figure 8: Rate of employment by demographic group and governorate ............................................................... 18

Figure 9: Average income and debt (USD) by governorate .................................................................................. 19

Figure 10: Proportion of households by most reported types of accommodation and governorate ...................... 20

Figure 11: Proportion of households by top 5 shelter issues ................................................................................ 21

Figure 12: Rates of access to antenatal and postnatal care, by governorate ....................................................... 23

Figure 13: Proportion of households by primary source of drinking water ............................................................ 23

Figure 14: Proportion of households who had experienced shortages of sources of water for non-drinking

purposes for 30 days or more since displacement ................................................................................................ 24

Figure 15: Proportion of households with private or shared latrine access by shelter type ................................... 24

Figure 16: Access to gender separate latrines amongst households sharing shelter with other households ....... 25

Figure 17: Proportion of school age population not attending formal education, by age group and gender ......... 25

Map 1: Assessed governorates and sample sizes across Iraq ............................................................................... 8

Map 2: Proportion of households reporting not having been able to access PDS assistance since displacement15

Map 3: Total employment rates in the month preceding assessment per governorate ......................................... 19

Map 4: Total proportion of all school aged children attending formal education, per governorate ........................ 26


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CONTEXTUAL OVERVIEW

The current Iraqi internal displacement crisis originated with conflict in Anbar governorate between Armed

Groups (AGs) and the Iraq Security Forces in late 2013, which in June 2014 rapidly spilled into Ninewa and other

central governorates of Iraq. The spread of insecurity spurred large scale displacement with 3,171,606 internally

displaced persons (IDPs) been identified across the country. By the end of July 2015, the governorates hosting

the majority of the IDP caseload were Anbar (18%), Baghdad (17%), Dahuk (13%), Kirkuk (13%), Erbil (9%) and

Ninewa (6%).7 As the conflict shows little sign of abating soon, most IDPs are unable to safely return home and

are facing either protracted displacement in their current location or multiple displacement to safer areas. Many

IDPs are in dire need of assistance and few have the capacity to deal with longer-term displacement.

The previous Multi-Cluster Needs Assessment (MCNA I), implemented in October 2014 by the REACH Initiative

(REACH) at the request of the Kurdistan Regional Government (KRG), represented the first baseline dataset on

broad multi-cluster priority needs of IDPs living outside camps in the KRI. When the MCNA I was conducted in

October 2014, the large majority of IDPs had recently fled hostilities in Anbar and Ninewa governorates and

sought refuge in Dahuk, Erbil and Sulaymaniyah governorates. The previous MCNA therefore specifically aimed

to understand the different living arrangements of these newly displaced families since arrival in the KRI; and to

inform government and humanitarian actors about the perceptions and priority needs of the displaced

populations. The priority needs of IDPs in the KRI as found in the MCNA I were preparation for the approaching

winter and food security. There was also some concern for shelter and WASH, especially by IDPs living in more

vulnerable shelter types. Livelihood and education were less commonly reported, likely a reflection of the recent

displacement and critical situation.

Since October last year, the dynamic of the conflict has changed, and as displacement has continued to grow,

and IDP destination trends have shifted significantly. Anbar and Baghdad governorates are now host to the

largest proportions of IDPs. Therefore, in line with the HRP’s Whole of Iraq approach, this second MCNA (MCNA

II) encompassed both the KRI and the rest of Iraq – in total 14 of 18 governorates were assessed.8 Overall the

MCNA II seeks to create a broad, multi-sectoral understanding of the situation facing the internally displaced

population living outside camps in Iraq, in order to better inform the humanitarian community and enable effective

prioritization assistance.

Key findings from the MCNA II assessment have been available to stakeholders from the second half July 2015.

This assessment was crucial in that it represented updated data and analysis of changing needs over time in the

KRI, whilst simultaneously establishing the baseline for multi-cluster needs in the centre-south. The MCNA II also

allowed for a comparison of varying IDP needs across most of the country. The timing of this report was

particularly important, as the dissemination of the preliminary findings, key analysis and datasets coincided with

the start of the planning cycle for the September Humanitarian Needs Overview for 2015. The MCNA II therefore

provided a quantitative evidence base for decision makers with the purpose of planning, sector prioritization and

for target group identification.

The first part of the report introduces the methodology designed and applied by REACH, followed by a profile of

the IDP populations covered by the assessment. The second part of the report outlines priority needs as reported

by the assessed population, together with sector specific assessment findings on food security, livelihoods,

shelter and non-food items, health, water and sanitation, and education of IDPs living outside camps, where

possible compared to findings of the previous MCNA.

7 International Organisation for Migration, Displacement Tracking Matrix, Round XXIV Report, July 2015. 8 Anbar, Baghdad, Kirkuk and Salah al Din governorates were not assessed due to security concerns and authorization issues.


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METHODOLOGY

The purpose of this assessment was to collect multi-cluster baseline data at the household level of IDP

households living outside camps across Iraq, and to identify gaps and opportunities in the provision of

humanitarian assistance to IDPs across Iraq. This seeks to better inform the humanitarian community and enable

effective prioritization of assistance. The assessment also sought to enable comparison over time between data

from the MCNA I, conducted in October 2014, and this second MCNA. Data collection took place between 14

May and 21 June, across accessible areas of all governorates of Iraq. As shown in Map 1, the assessment

covered accessible areas in 14 out of all 18 governorates across the country. Only Anbar, Baghdad, Kirkuk and

Salah al-Din were not included in the assessment due to security and authorization concerns at the time of data

collection.

The indicators and questionnaire9 for this assessment were based on the MCNA I (established in coordination

with the Ministry of Planning (MoP) of the Kurdistan Regional Government (KRG)), and were developed

collaboration with cluster leads to incorporate feedback from relevant KRG Ministry stakeholders and clusters

leads in response to the MCNA I.

Map 1: Assessed governorates and sample sizes across Iraq

The sampling frame for this assessment was calculated using the International Organisation for Migration (IOM)’s

Displacement Tracking Matrix (DTM) figures on specific locations and concentrations of IDPs not staying in

camps within each governorate at the time of assessment, to yield findings representative to the governorate

9 For the full questionnaire, please seen Annex I.


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level with a 10% margin of error and 95% level of confidence. Total sample sizes for each governorate range

between 258 and 491 households, giving a total sample size of 5,225 households (31,585 individuals).

Data was collected through household-level interviews. For the purpose of this assessment, a household unit

was defined as consisting of one head of household and all individuals residing within the boundaries of the

household sharing income and food – including family and non-family members.10 Interviews were conducted in

Arabic, conducted by mixed-gender teams using Open Data Kit (ODK) software on hand-held devices for

purposes of data-entry. The raw data was cleaned to eliminate demonstrably erroneous entries.

Following the preliminary analysis, REACH presented the initial findings to the Food Security, Water and

Sanitation Hygiene, Education, Protection, Shelter and NFI and Livelihoods and Social Cohesion clusters.

Feedback from cluster partners during and after presentations was encouraged. Where possible, these inputs

have been incorporated into this report, in order to include cluster-specific contextual knowledge and ensure

addressed indicators are relevant to cluster activities.

Data is generally presented at two levels in this report, both in the graphics and the narrative: disaggregated by

governorate, or generalized at the KRI level. Data presented at the KRI level has been weighted based on each

governorate’s displace population size. In most cases where data is presented at the KRI-level only, there was

no significant variation between governorates.

Limitations Anbar, Baghdad, Kirkuk and Salah al Din governorates were not assessed due to security concerns and

authorization issues at the time of assessment. The specific needs of the large proportions of IDPs residing in

these governorates, in particular Anbar (18%) and Baghdad (17%) are therefore not covered in the findings

outlined in this report. In addition, when looking at findings according to area of origin it should be noted that

according to the IOM DTM, Anbar and Baghdad host 72% of the IDPs from Anbar governorate. Therefore any

representative analysis of IDPs displaced from Anbar as a group is not possible in this report.

With regard to comparing findings with those in the previous MCNA in October 2014, certain limitations need to

be highlighted. Due to the changes in population sizes between October 2014 and June 2015, it is not possible

to directly compare statistical findings from the two rounds of data collection. Moreover, in order to ensure that

this second round of data collection was relevant to current humanitarian actors and stakeholders, some

indicators, definitions and disaggregation have been revised since the previous MCNA – thereby not all

indicators can be directly compared across the two assessments.

That said, as both assessments individually provide findings that can be generalised to the governorate level,

broader trends and observations are comparable and will be discussed in the report where appropriate.

Moreover, it should be noted that the overall confidence level of 95% applies to those findings which pertain to

the full sample. Any findings presented solely on subsets of the population – e.g. households who reported that

they could not afford basic needs – inevitably have a lower confidence level. In particular those findings which

relate to a very small subset of the population should therefore be treated as indicative only.

When reading this report and using findings presented herein, the reader should bear in mind that this

assessment represents the response given by beneficiaries. While REACH always endeavors to create an open

dialogue with respondents in order to collection objective responses, the subjectivity and possibility of bias in the

response should be taken into account.

10 In broader terms, a household could therefore be defined as a set of individuals or families sharing a corresponding shelter or set of shelters as well as income. It is important to note that a single household can, at times, host more than one family unit. In the field, the exact boundaries of each household unit – and therefore the number of individuals residing within it – were determined, where appropriate, on a self-defined basis by the head of household or the most senior household member available at the time of the assessment.


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KEY FINDINGS

This part of the report presents a profile of the IDP populations covered by the assessment, followed by sector

specific assessment findings on protection, food security, livelihoods, shelter and non-food items, health, water

and sanitation and education of IDPs.

Assessed population profile This section of the report outlines findings related to the assessed population profile, including demographics,

documentation and registration, assistance received and priority needs.

The average displaced household size in Iraq was 6.4 persons. The proportion of male (51%) and female (49%)

household members was split fairly evenly, while most families (91%) were headed by a male head of

household. Displaced household in Iraq featured a high level of dependency, at an average of 0.9. Taking

into account the large majority of male heads of households and low female employment rates (see

below), typically the children and women of the household were often reliant on a male head of the

household for income generation. This implies that for every ten individuals of working age, nine are not of

working age.

The IDP population across all assessed governorates included vulnerable groups who are likely to be less

capable of dealing with displacement. Compared to the central and southern governorates as a whole,

governorates in the KRI host a high proportion of households with vulnerable members. Across the assessed

governorates, 2% of interviewed families reported caring for a minor who was not part of their immediate family;

most of these cases were children who had been separated from their own family. Particularly large proportions

were identified in the KRI (Dahuk, Erbil, and Sulaymaniyah) and Missan and Kerbala governorates. In turn, 4% of

the IDP population was 60 years old and above – overall 13% of households had an elderly head of household,

with a noticeably larger proportion in Dahuk (18%). The KRI saw much larger proportions of males over the age

of 60 still earning an income: large proportions were not receiving pensions but were still engaged in active jobs.

Overall 11% of households had a member suffering from a disability: these proportions were slightly higher in the

KRI. The types of disabilities reported were most commonly either physical or speech impediments.

Documentation and Registration

While efforts to register all IDPs by the government appear to have been comprehensive, many IDPs are

missing other forms of civil documentation and are still lacking residency in their current location. The

overwhelming majority (96%) of the IDP population reported being registered with the Iraqi Ministry of

Displacement and Migration (MODM) or the Department of Displacement and Migration (DDM) in Dahuk, with

minimal variation across governorates. Of those registered with the MODM, 88% reported that they had received

the financial grant of one million Iraqi Dinar after registration. These findings indicate significant improvements in

registration processes in the KRI since the previous MCNA data collection round in October 2014, which found

that the majority of IDPs in the KRI at the time were not aware of their own registration status.11

Although the entry and residency documentation policy varies for each governorate and has been subject to

multiple changes in policy at the borders, at the time of assessment a larger proportion of IDPs in the KRI had

residency compared to the first MCNA in October 2014. Despite this, smaller proportions of IDPs had residency

in Dahuk (18%) and Sulaymaniyah (26%) than Erbil (62%). Moreover, Dahuk also hosted the largest proportion

of IDPs without any legal permission to remain (76%), compared to 20% in Erbil and 17% in Sulaymaniyah.

Further, many IDP households (16%) across Iraq reported missing other forms of civil documentation. 5% of the

11 REACH, Multi-Cluster Needs Assessment of Internally Displaced Persons Outside of Camps, Kurdistan Region of Iraq, February 2015

http://www.reachresourcecentre.info/system/files/resource-documents/reach_irq_report_multi_cluster_needs_assessment_of_idps_outside_camps_february_2015.pdf


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IDP population were missing their food ration card, 4% their passport and 3% their identification card. This

documentation is commonly lost due to hurried departure or confiscated whilst travelling, and often cannot be

obtained or renewed outside the governorate of origin. A lack of civil documentation and residency creates

difficulties in access to jobs, the public distribution system (PDS), public services and legal representation,

decreasing the capacity of IDPs to deal with their displacement.

Assistance Received

When looking at assistance received by households, only 8% of households reported not having

received any assistance since arrival in their current location. Most households had received food (83%) or

cash (75%) assistance at least once since arrival in their current location, while smaller proportions had received

other non-food items (including fuel, 32%).

Figure 1: Type of assistance received since arrival at their current location as reported by households

:

Significant variations were found between governorates in the proportion of IDPs reporting to have received cash

assistance, however these variations did not fall into a regional divide between the KRI and central-southern

governorates. For example, 81% of IDPs in Baghdad and 89% in Dahuk reported having received food

assistance, while 14% reported this in Qadissiya.

Although the proportion of households reporting to have received food assistance at least once since

their arrival at their current location of residency is largely equal across all assessed governorates, the

main source of this food assistance differed greatly between the KRI and neighbouring governorates

compared to central and southern governorates. In more northern governorates, food assistance was more

commonly received from INGOs rather than the government, while the opposite was true in central-southern Iraq.

For instance, while only 4% of households in Erbil and 8% in Diyala reported to have received food assistance

from the government, 61% and 90% respectively cited having received assistance from INGOs. In turn, in only

1% and 7% of households in Najaf and Qadissiya reported INGOs as their main food assistance source, but 36%

and 74% had received food assistance from the government. However, an average 63% in the centre and south

reported having received United Nations (UN) food assistance or support from the local community (23%),

whereas this was less frequently reported in the KRI and surrounding areas.

Winterization preparedness received by IDPs since displacement has been predominantly focused on

the KRI and neighbouring governorates, Ninewa and Diyala, in comparison to central and southern

governorates assessed. Shelter winterization assistance was found to have been received on average by a

slightly larger proportion of households in the KRI compared to central and southern governorates, but significant

variation was still found amongst these governorates – such as 23% in Dahuk and 7% in Erbil. In turn, there was

an even bigger imbalance between the north and south in relation to NFI assistance, with much larger


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proportions in the KRI and neighbouring governorates (an average 36%) than the centre-south apart from

Missan, Najaf and Wassit. This can in part be explained by the higher winterization need in the KRI due to

mountainous terrain and in part that during the previous winter period, comparatively heavier caseloads of IDPs

were residing in and around the KRI. Subsequently, the KRI attracted the bulk of international humanitarian

assistance during this period. Higher proportions in the more northern governorates received winterization

assistance from INGOs while those in the centre and south saw larger proportions from the local community and

local charities.

Priority Needs

IDPs were asked to cite their top three priority needs to be addressed.12 Overall the large majority of IDPs

were prioritizing immediate needs above specific long-term needs, despite 46% of households having

been displaced for a year. This indicates that few IDPs have been able to establish any stability in meeting their

basic needs since displacement. Across Iraq, the most commonly cited top priority need was food (72%),

followed by employment (42%) and medical care (25%). Shelter support (11%), and other NFIs (such as

clothing, 14%) as well as education (10%) were also often cited as key priorities.

Figure 2: Priority needs as reported by households

Governorate Food Employment Shelter support

Medical care

Water Education Clothing Registration

Babylon 69% 9% 1% 14% 7% 6% 40% 2%

Basrah 66% 32% 84% 16% 1% 3% 2% 1%

Dahuk 80% 32% 5% 30% 4% 6% 5% 0%

Diyala 94% 54% 15% 10% 0% 2% 4% 6%

Erbil 65% 52% 13% 33% 12% 19% 12% 3%

Kerbala 69% 45% 1% 36% 23% 25% 6% 0%

Missan 58% 86% 24% 10% 4% 24% 7% 1%

Muthanna 51% 20% 5% 19% 16% 3% 2% 26%

Najaf 11% 22% 16% 14% 7% 7% 23% 0%

Ninewa 76% 32% 12% 27% 3% 5% 7% 2%

Qadissiya 80% 11% 0% 6% 0% 2% 54% 0%

Sulaymaniyah 89% 64% 10% 12% 4% 7% 6% 2%

Thi-Qar 47% 36% 91% 40% 0% 0% 6% 0%

Wassit 36% 54% 29% 16% 14% 12% 16% 0%

Food assistance was reported as a key priority by the large majority of households in the KRI and

surrounding governorates, with slightly smaller proportions in the centre-south. In addition, food and

employment were reported as a priority need by a slightly larger proportion of households who had been

displaced prior to June 2014. Importantly, the reported need for employment has increased almost two-fold

in the KRI since the MCNA I. This indicates that IDPs who have been displaced for longer in the north are

starting to exhaust coping strategies available to them and struggling to maintain their basic food consumption.

In turn, IDPs who were displaced more recently and reside in the centre-southern governorates appear to

have been less able to access key household NFIs after displacement; shelter support was cited by more

households displaced since August 2014, while clothing and documentation were reported by larger proportions

of households who had arrived after April 2015. Shelter support was reported by much higher proportions in Thi-

Qar (91%) and Basrah (84%), while the need for clothing was noticeably more common in Qadissiya (54%) and

12 This question allowed for multiple choice answers, subsequently total values can exceed 100%.


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Babylon (40%). Noticeably, IDPs in Kerbala were found to be especially vulnerable in terms of immediate life-

saving needs: water (23%) and medical care (36%) was noticeably more commonly reported as a priority. As

such, the length and area of displacement was found to affect priority needs, with households that are longer

displaced in the KRI exhausting coping strategies to meet food needs while facing low employment, and those

more recently displaced in the south struggling with higher shelter needs and fewer household assets.

Food Security Despite the 83% of households who had reported receiving food assistance since arrival in their current

location, this is not indicative of the amount, frequency and quality of assistance received: when asked to

list their top three priority needs, food was the most commonly cited top priority need, by 72% of the IDP

population across Iraq. This was also the most reported priority in the KRI during the previous MCNA. As food is

an immediate and life-saving need, the fact that this has continued to be highlighted as a priority need for more

than one year into the humanitarian response to the Iraqi crisis indicates that the capacity of IDPs to deal with

protracted displacement remains low.

Food consumption scores (FCS), a measure of the frequency of consumption and the nutritional value of

food consumed, were generally higher in the KRI and neighbouring governorates than elsewhere in Iraq.

For the MENA region, including Iraq and Syria, WFP interprets an FCS score of 28 or under to indicate a poor

food consumption profile; a score from 28.1 through 42 to be borderline; and an FCS score above 42 to indicate

an acceptable food consumption profile of food security. Even though across Iraq the large majority of

households (94%) showed an acceptable FCS, IDPs residing in the Southern governorates of Muthanna and

Basrah registered some of the worst FCS outcomes of all governorates, averaging a score of 55 and 63,

respectively. This sharply contrasts with governorates in the North, for example the Dahuk and Erbil

governorates where the average FCS scores stood at 90 and 81 respectively. The KRI has seen an increase in

average food consumption scores since the previous MCNA: previously 22% of households had less than an

acceptable score, but now this amounted to less than 2%. The increase in acceptable food consumption scores

may be explained by several factors: a reported increase in access to PDS, a rise in residency, slightly higher

employment and income rates, and the expansion of food assistance programming outside camps since the

MCNA I.

Figure 3: Average Food Consumption Score, by governorate

Households who relied primarily on food support from the local community were the least food secure.

IDPs who received the majority of their food from local community assistance had a lower average FCS of 57,

compared to an average FCS of 77 if reliant on UN assistance, and an average FCS of 76 if food was bought

with cash. This suggests that IDPs are relying on support from communities as had few other source options to


14

complement their food consumption. In turn, the low scores indicate that community support systems have a

limited capacity to help IDPs meet their basic food needs.

That said, the majority of IDPs (83%) relied on cash

expenditure as their primary means to acquire food, whereby

few households are dependent on humanitarian food

assistance. Indeed, 82% of those who reported having

received food assistance since arrival in their current

location stated that cash purchases were still the main

method of food acquisition. Across the assessed

governorates only an average 5% of IDP households

reported their main source of food as UN (WFP) assistance.

However, dependency was found to be higher in Erbil (14%)

and Diyala (8%). Notably IDPs residing in Muthanna reported

the most diverse food sources, with 16% purchasing with

cash, 45% relying on local assistance schemes and 22%

relying on the government Public Distribution System (PDS).

On the one hand, the ability to access a range of different

food sources can mean that IDPs have a wider range of options, should one of their usual sources of food

become unavailable. However, a range of different food sources an also provide an indication of vulnerability in

that these households may not be able to afford purchasing their foods with cash, which is the standard main

source of food across Iraq.

Notably, distribution of the PDS - the monthly food ration for every Iraqi, which was introduced by the

central government in 1991 – is accessed by very different proportions of IDPs in the central southern

governorates compared to governorates in the KRI and surrounding governorates, with the exception of

from Dahuk. Across the assessed governorates, 40% of IDP households reported that they had been able to

access their PDS rations since displacement, whereas this was only reported by 7% in Erbil and 26% in

Sulaymaniyah. Moreover, many of the households in Erbil and Sulaymaniyah had received their latest ration

more than two months ago (63% and 20% respectively). Anecdotal evidence by food security cluster partners

suggests that lack of information of how to re-register with local authorities for access to PDS has been

particularly problematic in Erbil and Sulaymaniyah, while the heavy caseload of IDPs in Dahuk has attracted

much of the humanitarian response and resulted in better service provision.

Figure 4: Primary reported food sources


15

Map 2: Proportion of households reporting not having been able to access PDS assistance since displacement

Although most IDPs rely on cash purchases to acquire their food, higher food expenditure does not

necessarily translate to better food security and nutritional intake. For instance, the average food

expenditure per capita across Iraq was 51 USD, between 38 USD in Diyala and 68 USD in Basrah. Although

households spent the most on food per capita in Basrah, and in turn displayed the highest incomes and

employment rates (detailed further below), households also featured the second worst FCS scores. Moreover,

Iraq-wide IDP households are spending an average 50% of their income on food expenditures, which is

indicative of a limited capacity to spend on outstanding non-immediate needs. Notably, in Muthanna, households

are spending on average all of their earnings on food, pointing to particular vulnerability in terms of ability to

afford both food and other basic needs.

Still, the average amount spent on food did not vary as much between governorates as much as one might

expect in accordance with the relative variation of incomes. This could indicate the preference to prioritise

expenditure on immediate food needs, after which any other basic needs are prioritised, especially shelter.


16

Figure 5: Average reported household food expenditure and income in the 30 days preceding assessment (USD)

Moreover, high engagement in negative food coping strategies reveals significant challenges in

affording basic food needs and points to underlying food insecurity. Overall, across all assessed

governorates 68% of households were relying on less expensive food, 29% limiting their portions at mealtimes

and 18% reducing the number of meals eaten at least once a week. In fact, the governorates which saw the

higher FCS in the KRI and neighbouring governorates featured some of the highest proportions of households

engaged in negative food coping strategies, indicating that they feel the need to use behaviours that heighten

their vulnerability in order to meet an acceptable standard of food consumption. Many of these households have

also been displaced for more than a year, and the increasing use of more severe coping strategies which affect

the development of human capital, is not sustainable in the longer term. Missan, Muthanna and Wassit also show

higher rates of coping strategy engagement. In particular, more households in the central and southern

governorates compared to the KRI were engaging in severe strategies such as bartering, child labour and

reducing the amount of food consumed by adults in order to prioritise food for children.

Figure 6: Coping strategies as employed by households across all assessed governorates at least once a week

Taking into account the high rate of unemployment amongst IDPs in Iraq it is unlikely that households

will be able to sustain the same level of food consumption without assistance. This is particularly true for

those households reporting to be in debt, with higher rates of debt in the KRI and neighbouring governorates,

Basrah and Najaf. Indeed, 89% of households in debt said that this was due to meeting food costs. The average

family size of households in debt due to food was generally bigger, and almost all of the female headed

households in debt cited food as a reason for borrowing money. Interestingly, a slightly higher proportion of

households who arrived since April 2015 cited food as a reason across all governorates than those that arrived

before April 2015, apart from Dahuk. On the one hand, those families longer displaced in the KRI are sinking into


17

deeper debt to sustain food consumption patterns and may soon exhaust these strategies, while on the other

hand many of those newly displaced in the centre and south had been living under the occupation of AGs and

may have been forced to borrow money to meet food needs prior to displacement.

Livelihoods Employment was the second most reported priority need across Iraq, reported by 42% of households.

Noticeably, employment was reported by on average twice as many households in the KRI and neighbouring

Ninewa and Diayala, compared to the previous MCNA. Considering that many IDPs will be unable to safely

return to their area of origin any time soon, lack of access to livelihoods creates severe challenges for

sustainable capacity to deal with displacement and is often found to worsen social cohesion tensions in the area

of displacement.

The majority of IDPs do not have access to any regular, stable form of income, with particularly large

proportions reporting no livelihood at all in the centre-south. 17% of IDP households reported not

generating any form of income in the month preceding assessment, and 44% were relying on seasonal forms of

labour, including agricultural, skilled wage and low skilled wage labour to generate an income. Subsequently,

22% of households reported that they cannot afford all of their basic needs – amongst this subset of households,

food was the need most reported as unaffordable (74%), followed by shelter (61%), medical care (59%) and

water (26%).

The proportion of economically inactive households was highest in Muthanna (81%), Qadissiya (41%) and

Missan (33%), all predominantly rural governorates where the availability of jobs may have already been scarce.

Conversely, the proportion was lowest in governorates such as Sulaymaniyah (7%), Erbil (8%) and Basrah (8%);

essentially major urban areas serving as regional commercial hubs. This suggests a rise in income generating

activity in the KRI since October last year, when the previous MCNA found that 87% of IDP households in Erbil

and 90% in Dahuk reported not earning an income.

Figure 7: Proportion of households by primary source of income and governorate


18

Employment rates were also generally lower in the central-southern governorates compared to the north.

Overall, males between the ages of 18 and 59 engaged in the bulk of income generating activity, with 35% of this

demographic group reportedly employed overall. In Sulaymaniyah, Diyala and Erbil, employment rates for males

aged 18-59 reached a high of 74%, 56% and 53%, respectively, and a low of 3% in Qadissiya and 14% in Najaf.

8% of males and 1% of females aged 15-17 years were reportedly employed.

Figure 8: Rate of employment by demographic group and governorate

Despite low overall employment rates, in the KRI and neighbouring governorates, employment rates

amongst males increased by an average 48% between October 2014 and June 2015. In addition, the MCNA

found a rise (roughly 15%) in female headed households with females working in Dahuk, Erbil and Sulaymaniyah

and particularly in Ninewa. Previously none of the female headed households with females working reported

being in debt, but this is now the case in Diyala, Erbil and Ninewa. This indicates that female headed

households are struggling to provide for their families and resorting to negative coping strategies.


19

Map 3: Total employment rates in the month preceding assessment per governorate

Access to jobs appears to be particularly difficult for the IDP community as a direct result of

displacement and their status as IDPs. Indeed, 24% of households across all assessed governorates reported

that they have unemployed members who are looking for work. The main obstacle cited for not being able to find

work was increased competition (79%) as a result of swelling populations looking for livelihoods in areas hosting

IDPs. 18% also reported that refugees and other IDPs work for less. When looking at average incomes, again

IDPs residing in more urban environments were found to be more economically stable. Average incomes were

generally higher in governorates hosting major urban and commercial centres such as Erbil (510 USD), Dahuk

(553 USD) and Basrah (648 USD), than elsewhere – an average 477 USD across all assessed governorates.

Figure 9: Average income and debt (USD) by governorate

A high rate of engagement in coping mechanisms to deal with limited livelihoods was reported across all

assessed governorates, but particularly often in the KRI and neighbouring governorates. Across all

assessed governorates, 80% of the IDP population reported resorting to some form of coping mechanism to deal


20

with limited access to livelihoods over the course of the 30 days prior to the survey. A majority relied primarily on

spending savings (64%), charitable donations (31%) and kinship support networks (23%), and a sizeable

proportion also resorted to debt (22%) and the sale of assets (18%). Particularly high rates of debt were identified

in the KRI, neighbouring governorates (Ninewa and Diyala), and Basrah and Najaf. Moreover, the amount of

household debt was on average three times as large in the KRI as elsewhere in the country (3,191 USD

compared to 1,129 USD). In the KRI, the proportion of households in debt has remained similar but the average

amount of debt has quadrupled since the previous MCNA. Rent was reported by the majority of households in

debt as one of main reasons for borrowing money – especially Erbil (81%) and Sulaymaniyah (91%). The large

majority of households are in debt to friends and relatives either in the host or IDP community. This indicates that

many may soon exhaust borrowing money as a coping strategy and be forced to move to lower quality shelters.

Overall the high rate of coping strategies across Iraq raises concerns because facing protracted displacement

many households will soon exhaust all coping strategies available to them – once they have crossed this

threshold, their vulnerability and inability to meet basic needs is likely to increases sharply.

Shelter The central and southern governorates saw a higher proportion of households living in critical shelters

(informal settlements that are classified as critical shelters by partners, as they are often unfinished or

abandoned buildings, schools or religious centres, and informal tented settlements). Across Iraq the majority

(73%) of out-of-camp IDP households were residing in houses and/or apartments, whilst over 10% were residing

in abandoned or unfinished buildings and 2% were residing in schools. A larger proportion houses in the central

and southern governorates were living in religious buildings, and many in Wassit, Kerbala and Babylon were

hosted by local families along the traditional pilgrimage route.

Figure 10: Proportion of households by most reported types of accommodation and governorate

Governorate House Apartment Unfinished

building Abandoned

building School Hotel Container Tent

Babylon 59% 7% 4% 0% 3% 0% 0% 0%

Basrah 93% 6% 0% 0% 1% 0% 0% 0%

Dahuk 45% 17% 23% 1% 1% 5% 1% 3%

Diyala 73% 1% 24% 2% 0% 0% 0% 1%

Erbil 80% 10% 4% 0% 0% 4% 0% 2%

Kerbala 42% 7% 3% 11% 0% 12% 5% 0%

Missan 19% 43% 0% 0% 21% 0% 15% 2%

Muthanna 55% 6% 18% 13% 0% 2% 0% 0%

Najaf 26% 3% 3% 0% 0% 0% 0% 5%

Ninewa 56% 7% 26% 1% 4% 0% 0% 3%

Qadissiya 52% 17% 0% 0% 0% 0% 0% 0%

Sulaymaniyah 96% 1% 2% 0% 0% 0% 0% 0%

Thi-Qar 88% 5% 4% 0% 0% 0% 0% 0%

Wassit 20% 7% 8% 6% 6% 0% 0% 0%

Of those residing in houses or apartments, approximately 72% were reported as renting, raising

concerns over sustainability and affordability given the high rates of unemployment in the centre-south

and debt levels in the KRI. 84% of those citing rent as a reason for debt were living in houses, 8% in

apartments. As the crisis continues households may no longer be able to afford adequate shelter if rent prices

rise or income levels fall, possibly resulting in further displacement to less adequate shelters. For example,


21

compared to 2% across all groups reporting being threatened with eviction, 31% of households citing rent as

reason for debt reported being threatened with eviction.

Of those IDPs who reported intending to move within the next three months (4%), much higher proportions of

households in the KRI and neighbouring governorates who were currently renting said they planned to move due

to the cost of living whereas this was rarely reported in more central and southern governorates.

That said, at the time of assessment the main reasons cited for wanting to move within the next three

months were still related to problems with shelter quality rather than external factors, such as wanting to

be close to family or security.

The most common reason was seeking better

accommodation, followed by current building needed

for its intended use (such as schools or religious

buildings), overcrowding and better access to

essential services. Indeed, amongst households

living in critical shelters, more than half (56%)

did not feel that their shelter was of adequate

quality.

These proportions were generally higher in central

and southern governorates compared to the north,

apart from a similarly large proportion in Dahuk

(43%), mostly citing overcrowding and poor shelter

conditions. The poor quality of accommodation raises concerns for capacity to deal with the winter

weather, especially in more northern governorates where the winter climate is harsher and accommodation

issues were also frequently reported. The most commonly reported issues amongst households living in critical

shelters were related to overcrowding and general shelter conditions: lack of privacy (64%), too small (54%),

broken windows (30%) and leaking roof (27%). In addition, a high presence of vectors (36%) raises the risk of

transmission of disease.

In addition, similar proportions of households not living in critical shelters across all assessed

governorates reported issues with general shelter conditions, such as broken windows and leaking roofs. A

lack of heating was more commonly reported in the KRI. It should be noted that privacy was also reported by

large proportions not living in critical shelters in the KRI and neighbouring governorates.

Health 25% of IDP households reported medical care as one of their top three priority needs. In the KRI 16%

more households than the previous MCNA reported medical care as a primary need.

Problems accessing healthcare were especially common in Thi-Qar as well as the KRI and surrounding

areas. Findings indicate that the reason for the rise of healthcare as a priority need is that households are

foregoing healthcare in the face of limited finances in order to service other needs, such as food and

shelter.

Of the 92% of households who reported having sought medical care since their displacement, 35% reported

having experienced difficulties accessing care. The inability to access care when needed was especially common

in Thi-Qar (76%) as well as the KRI and surrounding areas (51% in Ninewa, 44% in Sulaymaniyah, 42% in

Dahuk, 40% in Diyala, and 36% in Erbil). The most frequently cited reasons for poor access were cost of

healthcare (65%) and insufficient funds to purchase medical supplies (35%), which indicates a potential

programming platform for targeted cash transfer activities in the health sector. A lack of medicine available at the

Figure 11: Proportion of households by top 5 shelter issues


22

hospital was reported by 26% of households. Other reasons, such as lack of staffing or problems with civil

documentation were only cited by a minority of households.

Immunisation rates against polio and measles were much lower in central-southern governorates than in

the northern governorates of Dahuk, Diyala, Erbil, Ninewa and Sulaymaniyah.

This raises acute concerns over the risk of infection amongst infants. Across all assessed governorates, 20% of

infants aged 0-59 months from IDP households were reported as not immunised against poliomyelitis (polio), and

70% of infants aged 9-23 months were reported as not immunised against measles. Immunisation rates for at-

risk infants were generally higher in the northern governorates of Dahuk, Diyala, Erbil, Ninewa and

Sulaymaniyah, where over 80% of infants aged 0-59 months were reportedly vaccinated against polio. In turn,

polio vaccination rates in Muthanna and Missan were as low as 28% and 36% respectively. In the same

governorates, only 4% and 6% respectively of at risk children were vaccinated against measles.

Figure 12: Reported polio and measles vaccination rates amongst at-risk population

Access to obstetric care was generally lower in central/southern governorates. For example, rates of

access to post-natal care were particularly low in Qadissiya (15%) and Muthanna (33%), and were on

average higher in the KRI and neighbouring areas (72%). Although problems accessing health care were

particularly high in Thi-Qar access to obstetric care was reported to be relatively high. All households in Thi Qar

with a pregnant women reported problems with access to medical care, the reasons for problems were largely

insufficient funds to purchase medicine rather than a lack of staff or facilities. It can be deduced that although

households forego expenditure on other medical needs in the face of financial constraints, they still invest where

possible on obstetric care. Almost 20% of households were found to host pregnant and lactating women.

The limited access to obstetric care raises acute concerns over the potential increase of health complications

during pregnancy and the availability of life-saving surgery during delivery, as well as limited adequate care for

new-born infants amongst IDPs.


23

Figure 12: Rates of access to antenatal and postnatal care, by governorate

Water and Sanitation Nearly 60% of the assessed IDP population relied primarily on some form of private source of drinking water.

Within this subset, over 40% purchased bottled water from private vendors, whereas 17% relied on trucked

water.

The reliance on purchased water was overwhelmingly high in southern governorates, for example

reported by 95% of households in Kerbala, 89% in Babylon and 84% in Wassit.

Of households drinking water from network

or natural sources, the large majority of

households in all governorates reported that

they did nothing to treat their drinking water

to make it safer, apart from Missan, Najaf and

Wassit. Contrary to the expectation, the data

does not suggest a direct link between

availability of safe drinking water and diarrhoea;

however this does not preclude residents using

unhygienic water supplies without being aware

of doing so. Notably, the recent confirmed

cases of cholera, in Baghdad and Najaf point

to unsafe drinking water practices in the area;

cholera is spread through drinking contaminated

water or eating food that has been in contact

with contaminated water. In particular in Najaf, amongst households not purchasing drinking water in a shop 3%

reported treating it through boiling, 17% adding chlorine and 20% filtering. In addition, 34% of households in

Najaf reported that they had suffered at least 30 days shortages of water for household purposes since

displacement. Lack of access to water for purposes other than drinking renders sanitized cooking practices

difficult.

There was no clear north-south divide in reported shortages of water for other purposes than drinking.

Apart from Najaf and Missan (30%) in the central south, shortages of 30 days or more since displacement were

slightly more commonly reported in the more northern KRI governorates of Erbil and Sulaymaniyah as well as

neighbouring Diyala and Ninewa. Whereas the clear majority (75%) of households in every governorate relied

primarily of municipal water supply to the house, (apart from Muthanna where 67% relied on water from a private

vendor), most of those facing water shortages were living in critical shelters and did not have access to a

water network connection inside the home.

Figure 13: Proportion of households by primary source of

drinking water


24

Figure 14: Proportion of households who had experienced shortages of sources of water for non-drinking purposes

for 30 days or more since displacement

Overwhelming majorities of IDPs in all governorates reported access to functional latrines, but access to

private latrines was much lower amongst IDPs living in critical shelters in more southern governorates.

Between 87% of households in Thi-Qar and 100% in Sulaymaniyah reported access to latrines – apart from only

40% in Muthanna. The lack of access to latrines in Muthanna raises concerns for sanitation and spread of

disease. The slight majority of IDPs across Iraq (62%) had access to private latrines, with lower proportions of

private access in Najaf (30%), Wassit (32%), Ninewa (48%) Diyala (50%) and Dahuk (51%). Unsurprisingly,

households living in less formal or more crowded shelter arrangements, such as containers, schools and tents,

were more likely to share latrines with other households.

Figure 15: Proportion of households with private or shared latrine access by shelter type

Shared latrines beyond the immediate household can raise protection concerns, if they are not separated by

gender or fitted with locks and lights. Amongst households sharing shelter with other families, reported

access to separate latrines for women and men was particularly low in southern governorates. Despite

this, the large majority (86%) of households across Iraq, between 66% in Diyala and 98% in Basrah, reported

that their latrines ensure privacy and safety (locks and lights) for women and girls.


25

Figure 16: Access to gender separate latrines amongst households sharing shelter with other households

Education IDP attendance in formal education is extremely low across Iraq, in particular in the central and southern

governorates. A big drop in formal school attendance amongst school-aged IDP children since

displacement has also been identified in the KRI, especially amongst children aged 12-15.

Figure 17: Proportion of school age population not attending formal education, by age group and gender

Governorate M 6-11 F 6-11 M 12-14 F 12-14 M 15-17 F 15-17

Babylon 88% 85% 96% 95% 95% 97%

Basrah 77% 76% 87% 97% 80% 91%

Dahuk 64% 72% 75% 80% 74% 82%

Diyala 45% 44% 77% 82% 47% 52%

Erbil 65% 65% 87% 88% 63% 70%

Kerbala 99% 99% 97% 99% 99% 100%

Missan 97% 99% 97% 99% 100% 100%

Muthanna 95% 95% 91% 97% 94% 99%

Najaf 63% 69% 77% 87% 69% 81%

Ninewa 73% 76% 81% 91% 76% 77%

Qadissiya 93% 95% 97% 98% 99% 93%

Sulaymaniyah 54% 43% 77% 75% 69% 81%

Thi-Qar 46% 54% 82% 86% 63% 72%

Wassit 53% 54% 77% 87% 65% 79%

Across all of the assessed governorates, only 20% of eligible IDP school-aged children attend formal education.

Attendance is overall higher in the KRI governorates of Dahuk (27%), Erbil (26%) and Sulaymaniyah (36%). In

comparison, attendance is significantly lower in central and southern governorates, particularly in Kerbala (1%),

Missan (2%) and Qadissiya (4%). Attendance rates were consistently lower for girls than for boys of the same

age group, a gap that is most striking between boys and girls aged 15-17. The lack of formal school

attendance is particularly concerning, as few children are receiving alternative forms of education:

attendance in informal education is 2% or less in all assessed governorates across all age groups and

genders.


26

Map 4: Total proportion of all school aged children attending formal education, per governorate

Reasons for non-attendance in the KRI and neighbouring governorates were more related to quality of

curriculum and language, whereas reasons in central-southern governorates were more closely linked to

movement and frequent displacement. Across all assessed governorates 38% of households hosting children

who do not attend formal education reported that a lack of funds for equipment was the largest challenge.

Frequently moving places was more commonly cited as a reason for non-attendance in the central and southern

governorates compared to more northern governorates – this reason accounting particularly for the low rates of

attendance in Missan and Qadissiya. Looking at the reasons for the lowest rates in Kerbala, the majority of

households reported that schools were too far away. In comparison, poor quality of curriculum and language

barriers were cited by many more IDP households residing in the KRI and neighbouring governorates.


27

CONCLUSION

The purpose of this assessment was to create a broad, multi-sectoral understanding of the situation facing the

internally displaced population living outside camps in Iraq, in particular to highlight their priority needs in order to

inform the planning of a more effective humanitarian response, including contributing to the Humanitarian Needs

Overview (HNO).

In the immediate term, food, water, and shelter have been reported as the priority needs for IDPs across

Iraq, with clear variation in needs between IDP communities located in the KRI and northern governorates

versus households residing in the centre or south of Iraq.

Assessment findings indicate that food should be considered a priority for humanitarian intervention, as the most

commonly cited immediate priority need across Iraq, reported by 72% of households. Notably, food has remained

the priority need in the KRI since the previous MCNA. As food is an immediate and life-saving need, the fact

that food is highlighted as a priority need for more than one year into the humanitarian response

indicates that the capacity of IDPs to deal with protracted displacement remains low. Most households

primarily purchase their own food, but are often forced to compromise on adequate food consumption in order to

allocate funds to other basic needs, such as shelter. In particular IDPs in the KRI - apart from Dahuk - are in

need of improved access to PDS rations, while increased UN and INGO food distributions in the centre

and south could help to raise the lower food consumption scores that were identified in the region.

Urgent programming gaps exist for targeted WASH interventions in the central-southern governorates, with large

proportions of IDPs living in temporary shelters (such as containers, tents and unfinished buildings) in

immediate need of access to adequate supplies of safe drinking water and sanitation facilities. Most of

these households displayed a heavy reliance on purchased water for drinking, indicating that regular supply

through municipal sources is either inadequate or considered unsafe for drinking. Recent confirmed cases of

cholera in Baghdad and Najaf highlight the consumption of contaminated water and subsequent significant

health risks.13

In terms of immediate shelter needs, many IDPs urgently need shelter winterization and NFI support in

order to prepare for the upcoming winter. The large proportions of households living in critical shelters in the

centre-south and Dahuk especially are exposed to overcrowding and poor shelter conditions. Moreover, in the

KRI a large number of IDP households are in debt due to rental costs and need cash assistance to avoid forced

displacement to higher risk accommodation arrangements during the winter season.

From a mid- to long-term perspective, programming needs to focus on sustainable, livelihood-based

assistance. Among an IDP population that is facing protracted displacement, this assessment found an

increased need for employment and a significant subsequent rise in engagement in negative coping strategies

since December 2014. The majority of IDPs across Iraq still do not have access to any regular, stable form

of income. A high rate of engagement in coping mechanisms to deal with limited livelihoods was reported across

all assessed governorates, but particularly in the KRI. For example, the level of debt in the KRI has quadrupled

since the previous MCNA. This debt has largely been taken to meet renting costs. Further, the rise in female

headed households with females working that are in debt indicates that female headed households in particular

are struggling to provide for their families. In the face of limited finances, many households are foregoing

food, shelter, medical and education costs.

This assessment found that access to jobs appears to be particularly difficult for the IDP community as a

direct result of displacement and their status as IDPs. Considering that many IDPs will be unable to safely

return to their area of origin any time soon, the likely continued competition for livelihoods could worsen social

13 Rudaw, ‘Cholera infections in Iraq climb to more than 500’, 30 September 2015

http://rudaw.net/english/middleeast/iraq/300920152


28

cohesion tensions between IDPs and host communities. A lack of change in livelihood opportunities is also

bound to perpetuate the severe challenges that IDP households face in their struggle to deal with displacement.

Many households will soon exhaust all coping strategies available to them – and once they have crossed

this threshold, their vulnerability and inability to meet basic needs is likely to increase drastically, putting

these households in need of immediate, life-saving assistance.

Last of all, clear variations in the conditions and levels of assistance received by IDPs in the northern

governorates compared to central and southern governorates need to be taken into account in a Whole-

of-Iraq approach. In particular the centre and south of Iraq remain relatively underserviced and are in need of

increased programmatic focus. Although IDPs in the KRI face severely constricted access to employment and

are thus foregoing critical needs such as medical care and education, IDPs displaced in the centre and south

have more restricted access to basic services overall and are more often exposed to immediate at-risk

environments. With larger proportions of households in the centre-south living in overcrowded, critical shelters,

their access to privacy and key municipal services, such as water provision, is considerably reduced. In addition,

access to life-saving postnatal care and vaccinations was lower in the centre and south, in part due to cost and in

part due to a lack of availability. Highlighting the vulnerable status of children in the centre-south, findings

indicate that formal education rates in the centre and south were found to be extremely low, with negligible

alternative forms of education available. If much-needed targeted interventions are to prove successful, it is clear

that these specific geographical differences will need to be taken into careful consideration.


29

ANNEX I

Table 1: Questionnaire used in the MCNA II household-level assessment

SECOND ROUND OF THE NON-CAMP IDP MULTI-CLUSTER NEEDS ASSESSMENT - IRAQ - MAY 2015

GPS location

N E Governorate District

Respondent gender Male Female Date [DD/MM/YY

]

A GENERAL - Household Profile

Where in Iraq were you living before your displacement (area of origin)?

Governorate District

How many members in each age group are in your household?

0-5 y 6-11 y 12-14 y 15-17 y 18-59 y

60 y and over

Male

Female

0-5 M

For those males aged 0-5, in which age group do they fall?

0-8 m 9-23 m 24-59 m

Male

0-5 F

For those females aged 0-5, in which age group do they fall?

0-8 m 9-23 m 24-59 m

Female

Please confirm that the total number of individuals in your household is:

What is the sex of the head of household? Male Female

What is the age of the head of household?

In the most recent 2 weeks, has the head of household suffered from any health issues? Yes No

Yes

Which health issues has the head of household suffered from?

Minor physical injuries Serious physical injuries /

Trauma

Respiratory tract infections Poor diet

Skin disease Swollen feet

Diarrhoea Extreme Stress Reactions

Other:

B GENERAL - Needs

What are your household's three priority needs?

Civil Documents Education for children Employment

Food Learn local language Medical Care

Shelter support Water Registration

Sanitation Vocational training Footwear

Clothing Psychosocial Support Other:

C GENERAL - Intentions

Do you intend to move to a different location? Yes No

Yes

Why do you intend to move? (multiple choice)

Eviction Building needed for intended purpose

Area not safe

Building not safe Harassment Overcrowding

Move to better

accommodation Cost of living To be near family


30

Weather conditions Better access to services Employment opportunities

Desire to go back

home Other:

Harassment

Who is being harrassed?

Boys Girls Women Men

Yes

Where do you intend to move to? Back to area of origin Same governorate

KRI

Elsewhere in KRI

Elsewhere in Iraq Outside Iraq Don't know

Yes

When do you intend to move? In the next 2 weeks Within one month (not next

2 weeks) Within 3 months (not this

month)

D EDUCATION

Are any individuals (6-17) in your household attending school? Yes No

Yes

Ages 6-11

Male Ages 6-11 Female

Ages 12-14 Male

Ages 12-14 Female

Ages 15-17 Male Ages 15- 17

Female

How many children (6-17) in your household are currently attending formal education?

How many children (6-17) in your household are currently attending an non-formal learning environment at least 4 days per week?

How many children (6-17) in your household are currently attending a single-shifted school?

How many children (6-17) in your household are currently attending a double-shifted school?

How many children (6-17) in your household are currently attending a triple-shifted school?

How many children (6-17) in your household have completely dropped out of school?

How many children (6-17) in your household have never attended school?

Please confirm that the number of children (6-17) in your household who do not attend any form of education is:


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>0

Why are these children not attending any form of education?

Because of the quality of the offered

curriculum

The child works to support the household

Lack of funds for school equipment

The school is too far away

Schools are overcrowded

Differences in language used

The child is married and cannot attend school

anymore. Safety issues

The children missed more than 3 years of school and are no longer

eligible

Other:

Safety issues

What kinds of safety

issues?

The school practices corporal

punishment Bullying

The commute to and from the school is dangerous

security-wise Other:

Harrassment in

school Harrassment on the

way to and from school

Are you willing to contribute to the costs of education? Yes No

Are you able to afford the necessary school supplies for your children to attend school? Yes No

No What can you not afford?

Books Writing

materials Bag Transportation School uniform Other:

E PROTECTION

6-11

Do the children aged 6-11 have access to a safe, child-friendly space outside of the home?

Male Yes No

Femal

e Yes No

12-14


Male Yes No

Femal

e Yes No

15-17


Male Yes No

Femal

e Yes No

Are you registered with the MoDM / DDM? Yes No

Yes

Have you received the financial grant from MoDM (1 mn IQD) following registration?

Yes No

Have any members of your household lost any civil documents?

Passport ID card Citizenship certificate

Food ration card Information card

KRI Which type of entry permit do you have? Tourist pass Residency card Leave to remain None

Residency Card + >12

How many HH members over the age of 12 have a residency card?

Males

Femal

es

Please confirm that the number of individuals (>12) in your household who do not have a residency card is:

Is your household currently caring for persons under the age of 18 for whom you do not normally provide care for?

Yes No

Yes

How many of these minors are related to you?

Males

How many minors which are not related to you at all?

Males

Females

Femal

es

Do you have regular and personal access to your local community leader? Yes No

How would you rate the degree of support you have received from your local community

Extremely helpful and welcoming

Good: welcoming

and supportive

with problems

Neither good nor bad

Bad: the community is not welcoming at all

Extremely bad: the community is

hostile


32

F FOOD SECURITY

Yesterday, how many meals were eaten by your family? (meals comparable to breakfast lunch, dinner)

Over the last 7 days, how many days did you consume the following foods?

CEREALS OR TUBERS (bread, pasta, wheat flour, rice, bulghur; potato, sweet potato)

MILK & DAIRY PRODUCTS

(milk, cheese, etc)

PULSES, NUTS & SEEDS (beans, chickpeas,

lentils, etc) EGGS

VEGETABLES (tomatoes, lettuce, cabbage) OIL & FATS

FRUITS (apples, oranges, bananas, etc) SWEETS (Sugar, honey, jam,

cakes, candy, etc)

MEAT OR FISH (red meat and chicken - including

the internal organs; fish, seafood) SPICES & CONDIMENTS

What was the main source of the food in the past 7 days?

Bought with cash Bought on credit Own production

Gifts from family /

friends Food assistance from

government Food assistance from UN

or INGO

Food assistance from

local charity / community

Other:

How much did your household spend on food in the past 30 days? IQD

During the last 7 days, did your HH lack food in any way? Yes No

During the last 7 days, how many days did your household have to employ one of the following strategies to cope with a lack of food or money to buy it?

Borrow food or relied on help from relative(s) or friend(s)

Limit portion size at mealtime (different from above: ie less

food per meal)

Restrict consumption by women in order for men and small children to

eat

Rely on less preferred and less expensive food (ie cheaper lower quality food)

Restrict consumption by men in

order for women and small children to eat

Reduce number of meals eaten in a day

Purchase food on credit Exchange food in order to have more diversity

Send household members younger

than 18 to work Other:

Since your displacement, have you been able to access your government Public Distribution System rations?

Yes No

Yes

When was the last time you received food through the PDS?

Over two months ago

Two months ago Last month This month

Yes

The last time, did you receive the full ration or half ration? Full ration Half ration

G HEALTH

Has any member of the household required health care since the displacement? Yes No

Yes

What medical treatment center did you go to?

Public hospital/clinic

Private hospital/clini

c NGO clinic Other:

Yes

Did any member of the household experience any problems in accessing the needed health care?

Yes No

Yes

Which of the following problems did members of the household experience in accessing the needed health care?

Public health clinic not open No treatment available for my disease/ problem at

the hospital

No treatment available for my disease/

problem at the public health clinic No medicine available at hospital

No medicine available at public health clinic Insufficient funds to purchase medicine at pharmacy

Did not get access to qualified health staff at

hospital Language barrier

Public health clinic did not provide referral No medicine available at pharmacy

No transport available Other:

Does any member of your household suffer from a chronic illness? Yes No


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Yes

How many members of your household suffer from a chronic illness?

Yes

How many of these household members are aged over 60?

<60 Please indicate which of the following chronic diseases the persons < 60 have suffered from:

Diabetes Asthma Heart disease

High blood pressure

Other:

>60 Please indicate which of the following chronic diseases the persons >60 have suffered from:

Diabetes Asthma Heart disease

High blood pressure

Other:

In the most recent 2 weeks, have any of the household members suffered from any health issues?

Yes No

Yes

How many children aged 5 and under have suffered from these issues in the most recent 2 weeks?

Minor physical injuries Serious physical injuries / Trauma



Extreme Stress Reactions Other health issue:

Diarrhoea

Yes

How many family members aged 6 to 59 have suffered from these issues in the most recent 2 weeks?





Diarrhoea

Yes

How many family members aged 60 and older have suffered from these issues in the most recent 2 weeks?





Diarrhoea

How many members of your household have any permanent disabilities?

Physical disabilities

Mental disability

Visual disability

Auditory disability

Speech disability

0-59

How many of the children under 5 have been vaccinated against polio? Don't know

10-23

How many of the children between the ages of 10 and 23 months have been vaccinated against measles?

Don't know

How many individuals currently under the age of 5 have been exclusively breastfed until the age of 6 months?

Is there any pregnant woman in your household? Yes No

Yes

Do the pregnant women have access to antenatal care? Yes No

Is there any lactating woman in your household? Yes No

Yes

Do the lactating women have access to postnatal care? Yes No

H LIVELIHOODS

In the last 30 days, what were the household's types of income-

Unskilled/agricultural waged labour

Low-skill service industry (janitor, waiter, etc.)

Skilled wage labour (eg. construction)

Practitioner of trade or vocation (carpenter,

Owner of small commercial business

Skilled service labour (lawyer, bank clerk)


34

generating activity (up to three choices)?

electrician, etc.)

Government employee, Public security official

(police, asayish, peshmerga)

Household is economically inactive

Other:

How many household members earned an income in the past 30 days?

6-11 y

12-14 y

15-17 y

18-59 y

60 y and over

Male

Female

What was the total combined income received in the past 30 days? I

QD

Please confirm that the number of individuals (>6) in your household who do not participate in income generation is:

Does your household have currently unemployed members who are actively seeking work?

Yes No

Yes

How many household members are actively seeking work?

Male Female

>0

For those who are not able to find work, what are the obstacles?

Increased competition for jobs;

not enough for everyone

Distance

Only low-skilled, socially

degrading or low-paid jobs are available

We are denied certain jobs

because we are displaced

Lack of family/personal

connections Other:

In total, how much did you spend on basic needs (food, water, shelter and urgent medical care)?

IQD

During the last 30 days, has your household been able to afford basic needs: food, water, shelter and urgent medical care?

Yes No

No If not, which essential needs could you not fully afford? (Select all applicable)

Food Water Shelter Urgent Medical

Care

Did the household engage in any of the following other activities to support themselves?

No Reduced essential non food expenditures such as education/health

Spent savings Sold household assets Support from Friends/

Relatives

Took on debt Charitable Donations Sold assistance received

Access to a previous

income source

Reduced household size through marriage of a

daughter <18

Other:

Debt

If the household took on debt, what is the current amount of the debt contracted since your displacement?

IQD

Debt

What were the reasons behind taking on debt?

Food

Health

Education

Clothing

Rent Busine

ss Service bills

Travel Other:

Debt

Where do you get access to credit ?

Relatives/friends within the host community

Relatives/friends within the IDPs community

Relatives/friends in the areas of origin

Money traders,

government Employers NGOs (micro-finance)

Financial institutions Other:

I NFI

What is your main type of fuel for cooking?

Electricity Gas Kerosene Wood Other:

How often have you experienced shortages in fuel Never Once or Every week Every day We had no fuel


35

for cooking in the last 30 days? twice at all

What is your main type of heating system?

Electric heater

Kerosene heater Blankets Wood fire

Gas heater Airconditioning

unit Other: _____ None

Do you have access to electricity? Yes No

Yes

What are your sources of electricity? Network Private

generator Common generator

Other:

Yes

How many hours do you usually have electricity per day? Less than 2

hours 2-6 hours 6-10 hours

More than 10 hours

J SHELTER

What is the type of shelter?

House Hotel Apartment Unfinished

building Abandoned

building

Open Air Tent School Other:

How do you provide the shelter?

Owned Rent Squatting

Hosted Other:

If not

owned Do you have any private space for your household alone? Yes No

Yes

What is the size of the area you have for your household in this accomodation? m2

No With how many other people do you share your accomodation?

No What is the total size of the accomodation? m2

Rent

How much rent do you currently pay per month? IQD

Rent

Do you have a written rental contract? Yes No

Yes For how long? Month

s

No Do you have an oral contract? Yes No

Yes For how long? Month

s

Are you currently being threatened of eviction? Yes No

Yes

How long have you been given to leave your current residence?

Immediately

Less than two weeks

Less than 1 month

Less than 3 months

More than 3 months

Do you feel this accommodation is of adequate quality? Yes No

No What are the primary issues?

Broken Windows Leaking Roof Damp

Lack of Heating Unhygienic Washing

Facilities Lack of Lighting

Lack of Privacy Not Secure Presence of Vectors

Not enough space Other:

K WASH

What is your main source of drinking water?

Purchased from shop

Water Trucking Dug well

Network (private)

Network (communal)

Other:

Do you treat your drinking water before consumption? Yes No

Yes

How do you treat it? Boil water Use a filter

Add chlorine to water Don't know

What is your main source water for cleaning and washing?

Purchased from shop

Water Trucking Dug well

Network (private)

Network (communal)

Other

Has that source of water for cleaning and washing ever suffered from a shortage of 30 days or more?

Yes No


36

Yes

What did you do to overcome that shortage?

Borrowed from

family/friends

Reduced consumption

of water

Borrowed money to buy

water

Spent money usually spent on other things to

buy water

Took water on credit from the shop

Nothing: stayed without water Other:

How do you dispose of your solid household waste? (select all that applies)

Rubbish Pit Communal Trash

Bin Collected by municipality

Burning Throw in open

space Other:

Which of the following hygiene items do you have access to? Soap Sanitary pads

Do you have access to a working latrine? Yes No

Yes

How would you rate the quality of the latrines you have access to?

Very bad Bad Average Good Very good

Yes

How many latrines are available for your household to use?

Yes

Is/Are the latrine(s) private for your household, or shared collectively? Private Shared

Share

d Are there separate latrines for men and for women? Yes No

Share

d How many people share this/these latrine?

Not

Separate In the case of unisex latrines, do the latrines ensure privacy and safety (locks and lights) for women and girls?

Yes No

L Social Cohesion

Have you noticed a change in levels of hospitality of the host community over the last month?

Yes No

Yes

Do you feel that levels of hospitality have: Increased a

lot Increased a little

Decreased a little

Decreased a lot

Have you noticed a change in levels of rates of small and petty crimes? Yes No

Yes

Do you feel that rates of small and petty crime have:

Increased a lot

Increased a little Decreased a

little Decreased a lot

How would you describe your household’s access to public services such as education, shelter, health and other services in the area in which you currently reside?

Excellent: we experience no

problems whatsoever

Good: access is

good but we experience

minor delays

Neutral

Bad: we experience delays and problems

Very bad: delays and denial of access from

local community and authorities

Bad; Very bad

Why do you feel that this is happening?

Public services are

bad in general in this area

There are more people

accessing these services so authorities

cannot cope

Insufficient funds to access high quality services

Host community gets preferential

treatment

We experience problems

because we are

displaced

There are more people

accessing these services so authorities

cannot cope

Other:

Over the last 3 months, do you feel that the cost of basic needs such as shelter, health and food has:

Increased a lot Increased a

little Stayed the same

Decreased a little

Decreased a lot

Have you been involved in any civil or legal disputes over the last 3 months? Yes No

Yes

What were these disputes over?

Land ownership

Shelter and housing

Family/social issues

Employment/jobs

Other:

M ASSISTANCE

Has your family received If yes, who provided this If yes, how If yes, when was the last time?


37

any of the following types of assistance since arrival in

your current location?

assistance? (select all that apply)

many times?

Cash

Government

UN

Local Charity

Red Cross Once Twice

Less than a week ago 1 - 4 weeks ago

Internation

al NGO Local

community

Other:___

Three or more times

1-2 months ago More than 2 months ago

Food

Government

UN

Local Charity



Internation

al NGO Local

community

Other:___

Three or more times


Water

Government

UN

Local Charity



Internation

al NGO Local

community

Other:___

Three or more times


Fuel

Government

UN

Local Charity



Internation

al NGO Local

community

Other:___

Three or more times


Shelter winterization

Government

UN

Local Charity

Red Cross

If yes, what did you receive?

Internation

al NGO Local

community

Other:___

Winterization items

Government

UN

Local Charity

Red Cross

Winter

clothes

Blankets

Carpets

Heater Winterization

Kit Other:

Internation

al NGO Local

community

Other:___

Other non-food items

Government

UN

Local Charity

Red Cross

Cleaning kit

Kitchen set

Hygiene kit

Sleeping/

shelter kit

NFI/CRI Kit

Other:

Internation

al NGO Local

community

Other:___